Be sure to complete all information on your form before submitting. Check that your contact information (email, phone, address, etc.) is current. We will contact you when all forms are complete. Student Information Name Email CIN Preferred Contact Number EOP Counselor Authorization to Release Program Enrollment Status/ Family Educational Rights and Privacy Act of 1974 as Amended (FERPA) Authorization declaration I hereby voluntarily authorize officials in the Educational Opportunity Program to specifically disclose my participation status with the program. This information is to be released to Los Angeles Department of Public Social Services in support of my application for CalFresh. Enter your electronic signature: Date CAPTCHA